The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff, although this varies widely depending on geographic location.

[3][4] Goran Haglund is credited with establishing the very first pediatric ICU in 1955; this PICU was located at Children’s Hospital of Goteburg in Sweden.

[6] As soon as 1966, another well-documented early pediatric intensive care unit opened at Kings County Hospital in Brooklyn, NY.

It was caring for patients with open heart surgery and peritoneal dialysis under the helm of Dr.

The establishment of these early units eventually led to hundreds of PICUs being developed across North America and Europe.

[5] Between 1930 and 1950 the poliomyelitis epidemic had created a greater need for adult respiratory intensive care, including the iron lung.

This monitoring could not be performed on the regular pediatric unit, which led to Children’s Hospital of Philadelphia’s development of the first American PICU.

This caused pediatricians to obtain skills in anesthesiology in order to make them more capable of treating critically ill pediatric patients.

This growth could be attributed to the advancement of medical care and the increased survival of children with chronic illnesses with the need for higher level of support.

The successful collaboration between nurses and physician has resulted in lower mortality rates not just in PICUs, but all intensive care units.

[14] Community-based PICUs were previously known as level II units and provide a broad range of services.

Quaternary or specialized PICUs serve large catchment areas and provide comprehensive care for complex patients.

[citation needed] There are a variety of certificates that are required for registered nurses to acquire in order to work in the PICU.

This certificate allows nurses to care for critically ill pediatric patients in any setting, not just the PICU.

[citation needed] There are a variety of factors that have led to poor outcomes in PICU patients.

The main factor that leads to inadequate care for PICU patients is improper health assessment by the healthcare providers.

This includes being able to recognize signs of deteriorating clinical status and perform proper triage of patients.

The staff often work for long periods of time in order to stabilize the most critically ill pediatric patients.

All of this causes the staff a great deal of stress and each member of the unit must develop their own coping mechanisms in order to prevent burnout.